Primary Care Physician Experiences with Integrated Population-Scale Genetic Testing: A Mixed-Methods Assessment.
Amy A LemkeLaura M AmendolaKristine Marie KuchtaHenry M DunnenbergerJennifer ThompsonChristian JohnsonNadim IlbawiLauren OshmanPeter J HulickPublished in: Journal of personalized medicine (2020)
The scalable delivery of genomic medicine requires collaboration between genetics and non-genetics providers. Thus, it is essential to investigate and address the perceived value of and barriers to incorporating genetic testing into the clinical practice of primary care providers (PCPs). We used a mixed-methods approach of qualitative interviews and surveys to explore the experience of PCPs involved in the pilot DNA-10K population genetic testing program. Similar to previous research, PCPs reported low confidence with tasks related to ordering, interpreting and managing the results of genetic tests, and identified the need for additional education. PCPs endorsed high levels of utility for patients and their families but noted logistical challenges to incorporating genetic testing into their practice. Overall PCPs were not familiar with the United States' Genetic Information Nondiscrimination Act and they expressed high levels of concern for patient data privacy and potential insurance discrimination. This PCP feedback led to the development and implementation of several processes to improve the PCP experience with the DNA-10K program. These results contribute to the knowledge base regarding genomic implementation using a mixed provider model and may be beneficial for institutions developing similar clinical programs.
Keyphrases
- primary care
- quality improvement
- healthcare
- copy number
- end stage renal disease
- study protocol
- circulating tumor
- clinical practice
- general practice
- mental health
- newly diagnosed
- genome wide
- cell free
- chronic kidney disease
- ejection fraction
- systematic review
- big data
- public health
- electronic health record
- prognostic factors
- case report
- social support
- physical activity
- randomized controlled trial
- working memory
- peritoneal dialysis
- cross sectional
- gene expression
- dna methylation
- clinical trial
- emergency department
- social media
- machine learning
- deep learning
- patient reported outcomes
- data analysis
- circulating tumor cells
- light emitting